Moving a Client in Bed

   Prolonged immobility is uncomfortable. It can  cause muscle wasting, promotes clot formation, and encourages skin breakdown. Clients who are unable to move themselves in bed or are only able to assist with moving in bed are at risk for discomfort  and skin breakdown. Often clients’ restlessness in bed will cause them to slide down toward the foot of the bed. This is especially true in beds where the head raises up to a Fowler’s or semi-Fowler’s position. If the client slides down

toward the foot of the bed while the head is elevated, it can lead to reduced respiratory effort and reduced lung capacity.

This can impair the client’s recovery.

The nurse is often called upon to move a client to a more comfortable position. Repositioning a client can sometimes be done by a single staff member, but

often it requires two or more people to do this procedure safely Assess the client’s ability to assist with repositioning. Determine if the client can move with the aid

of an overhead trapeze or the side rail. Judge how much assistance will be needed.

 Determines safety for the client and the nurse and good body mechanics    for the nurse.

1.     Assess the client’s ability to assist with repositioning. Determine if the client can move with the aid of an overhead trapeze or the side rail. Judge how much assistance will be needed.

2. Assess the client’s ability to understand and follow directions and assist and cooperate with the move. Affects how the procedure will be carried out. Affects client teaching.

2.     Assess the client’s environment. Check the bed for cleanliness. Has the client been restless, sweaty, or incontinent? Check to see if the sheets have been turned or twisted. Tubes, lines, wires, traction, casts, or splints must be moved carefully  Affects how the procedure will be carried out. Affects what additional procedures will


 

     Moving a Client Up in Bed with One Nurse

1. Wash hands.

2. Inform client of reason for the move and how to assist (if able).

3. Elevate bed to just below waist height. Lower head of bed if tolerated by client. Lower side rails on the side where you are standing. Remove the pillow and place it against the headboard.

4. Have the client fold arms across the chest.

5. Have client hold on to the overhead trapeze, if available Have the client bend the knees and place the feet flat on the bed if able (see Figure 4-4-6).

6. Stand at an angle to the head of the bed, feet apart, knees bent, feet toward the head of the bed.

7. Slide one hand and arm under the client’s shoulder, the other under the client’s thigh.

8. Rock forward toward the head of the bed, lifting the client with you. Simultaneously have the client push with the legs.

9. If the client has a trapeze, have the client pull up holding onto the trapeze as you move the client upward in bed.

10. Repeat these steps until the client is high enough in bed.

11. Return the client’s pillow under the head.

12. Elevate head of bed, if tolerated by client.

13. Adjust the client’s bedclothes as needed for comfort.

14. Lower bed and elevate side rails.

15. Wash hands.


Moving a Client Up in Bed with Two or More Nurses

1. Wash hands and apply gloves if needed Inform client of reason for the move and how to assist (if able).

2. Elevate bed to just below waist height. Lower head of bed if tolerated by client. Lower side rails.

3. With two nurses, place turn/draw sheet under client’s back and head.

4. Roll up the draw sheet on each side until it is next to the client

5. The nurses stand on either side of the bed, at an angle to the head of the bed.They stand with knees flexed, feet apart in a wide stance.

6. The nurses hold their elbows as close as possible to their bodies.

7. The nurses will lift up (off the bed) on the turn/draw sheet and forward (toward the head of the bed) in one smooth motion.The move is coordinated to transfer the client toward the head of the bed. Simultaneously, have the client push with the  legs or pull using the trapeze.

8. Repeat until the client is high enough in bed to be comfortable.

9. Return the client’s pillow under the head.

10. Elevate head of bed, if tolerated by client. Assess client for comfort.

11. Adjust the client’s bedclothes for comfort.

12. Lower bed and elevate side rails.